AB0910 GASTRIC DYSRHYTHMIAS IN PATIENTS WITH EARLY SYSTEMIC SCLEROSIS PROSPECTIVE CROSS-SECTIONAL STUDY
Authors: D. Seelmann, M. P. Poblete, S. Saavedra, A. M. Madrid, C. Von Muhlenbrock, C. Estay, A. Goecke
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis (SSc) is an autoimmune disorder characterized by vasculopathy and fibrosis of skin and internal organs. Gastrointestinal (GI) system is affected in up to 90% of patients and dysmotility is the primary abnormality [1]. Gastric dismotility contributes to esophageal symptoms and causes nausea, vomiting, abdominal bloating, and early satiety. It also impacts quality of life and when severe is associated with increased mortality [2]. GI dysmotility can be evaluated with Electrogastrography (EGG), a non-invasive and safe test. It measures gastric myoelectrical activity, and when impaired it predicts delayed gastric emptying with an accuracy of 85% [3]. To the date gastric involvement in patients with early SSc has not been directly studied. <h3>Objectives</h3> Describe the prevalence of gastric dysrhythmias in early SSc and the association between GI symptoms and GI dysmotility. <h3>Methods</h3> SSc patients fulfilling the 2013 ACR/EULAR classification criteria with early disease (≤ 3 years from the first non-Raynaud symptom) were included and cross-sectionally assessed. Pregnancy and Diabetes Mellitus were exclusion criteria. All patients signed informed consent. GI symptoms were assessed using the UCLA GIT 2.0 questionnaire [4]. Gastric myoelectrical activity was measured using surface EGG and informed as preprandial, postprandial or continuous brady or tachygastria. Continuous bradygastria was considered a severe abnormality. It was informed by an expert gastroenterologist blinded to patient characteristics. Statistical analyses: Categorical variables were described as frequencies and percentages, and quantitative variables as mean, SD and IQR. The associations between variables were analyzed using the Fisher exact test. Statistical significancy was defined as p &lt; 0,05 <h3>Results</h3> 30 patients were included, 96,6 % were female, with a mean age of 48.7 years (25–72 years). SSc was limited in 76.6%. 14/28 patients had an anticentromere antinuclear antibody pattern and 6 had anti Scl 70. Organ involvement was interstitial lung disease in 7/29, altered echocardiogram in 10/25 and erosive esophagitis in 11/15. Half of the patients were under immunosuppressive treatment, 43% on methotrexate and 50% mycophenolate. EGG was abnormal in 28/29 patients, 71.4% had bradygastria, 10.7% tachygastria an 17.8% mixed. Bradygastria was mostly preprandial (45%) and continuous (50%). According to the UCLA GIT 2.0 questionnaire, two thirds of the patients had a moderate to severe GI involvement. Other score items are described in Table 1. There was no correlation between symptoms and severity of the gastric motility disorder, but the presence of bradygastria was associated to a worse social functioning score (p 0, 018). <h3>Conclusion</h3> Gastric dysrhythmias, especially bradygastria occurs early in systemic sclerosis. Bradygastria was associated with a worse social functioning score. <h3>References</h3> [1]Jaeger VK, Wirz EG, Allanore <i>et al.</i> Incidences and risk factors of organ manifestations in the early course of systemic sclerosis: a longitudinal EUSTAR study. <i>PloS One</i> 2016; 11: e0163894. [2]Steen V, Medsger T. Severe organ involvement in systemic sclerosis with diffuse scleroderma. Arthritis Rheum 2000; 43: 2437–44. [3]Lisse J, Chen JD. Characterization of Gastric Myoelectrical Rhythms in Patients with Systemic Sclerosis Using Multichannel Surface Electrogastrography. Digestive Diseases and Sciences, Vol. 47, No. 4 (April 2002), pp. 690–698 [4]Khanna D, Hays RD <i>et al.</i> Reliability and validity of the University of California, Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument. <i>Arthritis Rheum</i> 2009; 61: 1257- 63. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.